1High ematogenicity for IV chemotherapy
>90%
2Medium ematogenicity for IV chemotherapy
30-90%
3low ematogenicity for IV chemotherapy
10-30%
4Minimal ematogenicity for IV chemotherapy
<10%
5Moderate to high ematogenicity for oral chemotherapy
>30%
6Minimal-low ematogenicity for oral chemotherapy
<30%
7CINV risk factors
<50 years old
female
history of morning sickness/motion sickness
history of poor CINV control
depression/anxiety
8CINV acute phase
enterocromaffin cells of GI tract damaged, serotonin release, activate 5HT3 receptors to cause NV
9CINV delayed phase
dopamine/substance p release activating NK1 receptors to cause NV
10CINV high risk gold standard prevention
Quadruplet therapy
5HT3RA
dexamethasone
NK1RA
olanzapine
all given day 1, olanzapine and dexamethasone continued days 2-4
11CINV med risk gold standard
double therapy
5HT3RA
dexamethasone
either one continued for 2-3 days
12CINV low risk gold standard
5HT3RA or dexamethasone given one time for prevention of acute NV
13CINV high to moderate oral gold standard
5HT3RA daily
14CINV low-med oral gold standard
metaclopramide
prochlorperazine
or 5HT3RA
daily as needed
15treatment for anticipatory CINV
lorazepam
16What are the drugs that end in "pitant"?
NK1RAs, used for high emesis chemotherapy. Aprepitant, rolapitant, etc
17Max IV dose of ondansetron?
16mg